Sharon Aycock, PA-C
Individual provider Active NPI Physician Assistant · Peoria, IL
NPI 1104813997 · NPPES record last updated Nov 8, 2013
Key facts
- NPI
- 1104813997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085000729 (IL)
- Practice address
- 200 E Pennsylvania Ave
Suite 105
Peoria, IL 61603-3089 - Phone
- (309) 655-7888
- Fax
- (309) 655-7905
- NPI assigned
- Oct 5, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 683-8156
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040311001088 | IL | Practitioner - Physician Assistant | 2567351299 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085000729 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients |
Locations
5114 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 655-2431
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
200 E Pennsylvania Ave
Ste 105
Peoria, IL 61603
Phone (309) 644-7888
5114 N Glen Park Place Rd
Ste 220
Peoria, IL 61614
Phone (309) 683-8100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085000729 | IL | Yes |
Addresses
Primary practice location
200 E Pennsylvania Ave
Suite 105
Peoria, IL 61603-3089
Mailing address
200 E Pennsylvania Ave
Suite 105
Peoria, IL 61603-3089
Phone (309) 655-7888
Other providers in Peoria, IL
- Aunt Martha'S Health and Wellness, Inc.
- Aunt Martha'S Health and Wellness, Inc.
- Angela L Ausili
- Thea Anne Austin
- Steven E Axne
- Kathryn Ayers
- John J Ayres
- Leen Ayyoub
- Sabiya Azim
- B & B Counseling Services, LLC
All providers in Peoria, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.